Bronchopulmonary Dysplasia (BPD)
Supplements studied for bronchopulmonary dysplasia (BPD).
Overview
Supplement research for bronchopulmonary dysplasia (BPD) in premature infants has focused on several agents, with mixed results. Vitamin A given by injection appears to have the strongest evidence among top supplements here, with nine studies suggesting it may lower BPD risk in low-birth-weight preterm infants at certain doses; lower doses or other forms may not show the same effect.
By contrast, N-Acetyl Cysteine (NAC) given directly into the lungs, oral Vitamin E, and Fish Oil have not shown clear benefit in available trials, including a large preterm infant study of fish oil. Lutein lacks sufficient evidence to judge. See the heatmap and evidence reviews below for supplement-by-supplement detail.
Effect graph
Relevant supplements
Relevant supplements sorted by DEX Score.
| Vitamin D | ★★★★★ | Low |
| Melatonin | ★★★★★ | Low |
| Vitamin A | ★★★★★ | Very Low / None |
| Vitamin E | ★★★★★ | Very Low / None |
| Fish Oil | ★★★★★ | Very Low / None |
| Zeaxanthin | ★★★★★ | Very Low / None |
| N-Acetyl Cysteine (NAC) | ★★★★★ | Very Low / None |
| Lutein | ★★★★★ | Very Low / None |
| Algal Oil | ★★★★★ | Very Low / None |
Studies
Find individual evidence reviews for supplements sorted by DEX Score.
9 supplements for and rated at least stars. All purchase bands. No minimum star filter.
Vitamin DView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Research has found that babies born with low vitamin D levels have about twice the chance of developing bronchopulmonary dysplasia, a lung condition.
- It is still unknown whether giving vitamin D supplements helps prevent or treat this condition.
Browse 1 study·1 meta-analysis
MetaAssociation between vitamin D level and bronchopulmonary dysplasia: A systematic review and meta-analysis2020n=8
A meta-analysis of 909 infants found vitamin D deficiency at birth associated with bronchopulmonary dysplasia (OR 2.41) in preterm neonates.
- Effect
- Benefit
- Population
- Adults
- Participants
- 8
MelatoninView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- In a small study of premature babies with breathing problems, those given melatonin 3 mg daily for 7 days had lower rates of chronic lung disease (45% vs 60%) compared to those not given melatonin.
- Melatonin also reduced time in the hospital, the need for breathing machines, and the risk of death.
Browse 1 study
RCTEvaluation of melatonin efficacy in prevention of bronchopulmonary dysplasia in preterm newborn infants2022
An RCT of 80 preterm infants with respiratory distress found melatonin 5 mg/kg/day for 3 days reduced BPD incidence (45% vs 60%), mortality, and hospital stay vs surfactant alone.
- Effect
- Benefit
- Duration
- 3 days
- Dose
- 5 mg/kg
- Population
- Infants
- Ages
- 27–32 weeks
Vitamin AView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Vitamin A given as an injection may help prevent a serious lung condition called bronchopulmonary dysplasia (BPD) in premature babies with low birth weights.
- Studies show that giving 5000 IU of vitamin A three times a week for about four weeks can lower the chance of developing BPD.
- Lower doses or taking vitamin A by mouth haven't been proven to help reduce BPD.
Browse 9 studies·4 meta-analyses
MetaThe Relationship of Vitamin A and Neonatal Respiratory Diseases: A Meta-Analysis2024
A meta-analysis of 24 studies found vitamin A deficiency was associated with higher neonatal respiratory disease risk (OR 4.86), while vitamin A supplementation improved outcomes for NRDS and bronchopulmonary dysplasia.
- Effect
- Benefit
- Population
- Infants
MetaEnteral Low-Dose Vitamin A Supplementation in Preterm or Low Birth Weight Infants to Prevent Morbidity and Mortality: a Systematic Review and Meta-analysis2022n=36
A meta-analysis of 4 trials (800 very low birth weight infants) found low-dose enteral vitamin A increased serum retinol but had no effect on mortality, sepsis, BPD, or hospital stay.
- Effect
- No Benefit
- Duration
- 26–32 weeks
- Dose
- ≤10000 IU/day vitamin A
- Population
- Infants
- Participants
- 36
MetaOral vitamin A supplementation in preterm infants to improve health outcomes: A systematic review and meta-analysis2022n=800
A meta-analysis of 4 RCTs (800 preterm infants) found oral vitamin A did not reduce mechanical ventilation duration or BPD at 36 weeks but shortened noninvasive ventilation by about 1 day.
- Effect
- No Benefit
- Population
- Infants
- Participants
- 800
RCTShould Vitamin A Injections to Prevent Bronchopulmonary Dysplasia or Death Be Reserved for High-Risk Infants? Reanalysis of the National Institute of Child Health and Human Development Neonatal Research Network Randomized Trial2021n=405
A reanalysis of the NICHD vitamin A trial (807 infants) found treatment benefit for BPD or death was greater in lower-risk infants (25% predicted risk: RR 0.73) than higher-risk infants (75% risk: RR 0.96).
- Effect
- Benefit
- Duration
- 4 weeks
- Dose
- 5000 IU/day
- Population
- Preterm infants
- Participants
- 405
MetaVitamin A supplementation prevents the bronchopulmonary dysplasia in premature infants: A systematic review and meta-analysis2021n=1,409
A meta-analysis of 9 RCTs (1,409 preterm infants) found vitamin A supplementation reduced BPD incidence (OR 0.67, 95% CI 0.52–0.88) without affecting mortality, ROP, or NEC.
- Effect
- Benefit
- Population
- Infants
- Participants
- 1,409
RCTVitamin A supplementation for extremely-low-birth-weight infants. National Institute of Child Health and Human Development Neonatal Research Network1999n=807
An RCT of 807 extremely low birth weight infants found intramuscular vitamin A 5000 IU three times weekly for 4 weeks reduced BPD or death at 36 weeks (55% vs 62%, RR 0.89) with 1 additional survivor without BPD per 14–15 treated infants.
- Effect
- Benefit
- Duration
- 4 weeks
- Dose
- 5000 IU/day
- Population
- Extremely low birth weight infants
- Participants
- 807
Clinical trialVitamin A to prevent bronchopulmonary dysplasia in very-low-birth-weight infants: has the dose been too low? The NICHD Neonatal Research Network1997n=91
A pilot dose-finding study of 91 VLBW infants found 5000 IU vitamin A three times weekly achieved target serum retinol levels, whereas lower doses did not, with no clinical toxicity observed.
- Duration
- 4 weeks
- Dose
- 2143 IU/day
- Population
- Preterm infants
- Participants
- 91
RCTTrial of vitamin A supplementation in very low birth weight infants at risk for bronchopulmonary dysplasia1992n=27
An RCT of 49 VLBW infants found intramuscular retinyl palmitate 2000 IU every other day did not reduce BPD incidence (48% vs 55%) compared with placebo.
- Effect
- No Benefit
- Duration
- 4 weeks
- Dose
- 2000 IU retinyl palmitate
- Population
- Very low birth weight infants
- Participants
- 27
RCTClinical trial of vitamin A supplementation in infants susceptible to bronchopulmonary dysplasia1987n=20
An RCT of 40 VLBW neonates found vitamin A 2000 IU every other day for 28 days reduced BPD (9/20 vs 17/20, P<0.008) and mechanical ventilation need at day 28.
- Effect
- Benefit
- Duration
- 28 days
- Dose
- 2000 IU/day
- Population
- Infants
- Participants
- 20
Fish OilView supplement →
Do not purchase·★★★★★
How we scored this▸
- Giving fish oil by mouth to preterm babies does not seem to prevent bronchopulmonary dysplasia, a type of lung problem.
- Studies with over 3,500 preterm infants found that fish oil, whether mixed into formula or given directly, did not lower the chance of getting this lung condition.
Browse 1 study·1 meta-analysis
MetaOmega-3 Long-chain Polyunsaturated Fatty Acids for Bronchopulmonary Dysplasia: A Meta-analysis2019
A meta-analysis of 14 studies with 3531 preterm infants found that fish oil supplementation did not reduce the incidence of BPD in preterm infants. [10606]
- Effect
- No Benefit
- Population
- Infants
Vitamin EView supplement →
Do not purchase·★★★★★
How we scored this▸
- Taking vitamin E by mouth does not prevent lung problems called bronchopulmonary dysplasia in premature babies weighing under 1500 grams.
- Studies show no benefit compared to placebo.
Browse 2 studies
Systematic reviewVitamin E supplementation for prevention of morbidity and mortality in preterm infants2003
A Cochrane review of 26 trials found vitamin E in preterm infants reduced intraventricular hemorrhage but increased sepsis risk (RR 1.52); evidence does not support routine high-dose use.
- Effect
- No Benefit
- Dose
- 3.5 mg/day
- Population
- Infants
RCTFailure of vitamin E supplementation to prevent bronchopulmonary dysplasia in infants <1,500 g1991n=268
In an RCT of 268 infants <1,500 g, oral vitamin E 25 units/day did not reduce bronchopulmonary dysplasia, death, necrotizing enterocolitis, or sepsis versus placebo.
- Effect
- No Benefit
- Dose
- 25 units vitamin E/day
- Population
- Adults
- Participants
- 268
Algal OilView supplement →
Do not purchase·★★★★★
How we scored this▸
- Giving DHA-enriched algal oil to mothers of very premature babies does not seem to prevent lung problems called bronchopulmonary dysplasia (BPD) in their babies.
- One study showed no improvement in survival or lung health, and more babies in the DHA group developed BPD.
Browse 1 study
RCTEffect of Maternal Docosahexaenoic Acid Supplementation on Bronchopulmonary Dysplasia-Free Survival in Breastfed Preterm Infants: A Randomized Clinical Trial2020n=528
An RCT in 528 breastfed preterm infants found maternal DHA 1.2 g/day did not improve bronchopulmonary dysplasia-free survival at 36 weeks; BPD was actually more common in the DHA group (41.7% vs 31.4%).
- Effect
- No Benefit
- Duration
- 36 weeks postmenstrual age
- Dose
- 1.2 g/day
- Population
- Women
- Participants
- 528
LuteinView supplement →
Do not purchase·★★★★★
How we scored this▸
- There is not enough evidence to determine if lutein has any benefit for Bronchopulmonary dysplasia.
Browse 1 study
RCTLutein and zeaxanthin supplementation in preterm very low-birth-weight neonates in neonatal intensive care units: a multicenter randomized controlled trial2013n=229
In a multicenter RCT in preterm infants, lutein/zeaxanthin supplementation did not significantly reduce retinopathy of prematurity, NEC, or BPD versus placebo.
- Effect
- No Benefit
- Dose
- 0.14 mg lutein + 0.0006 mg zeaxanthin/day
- Population
- Infants
- Participants
- 229
N-Acetyl Cysteine (NAC)View supplement →
Do not purchase·★★★★★
How we scored this▸
- Giving N-acetylcysteine directly into the lungs does not prevent or improve lung disease in premature babies and does not reduce the risk of bronchopulmonary dysplasia.
Browse 2 studies
RCTN-acetylcysteine does not prevent bronchopulmonary dysplasia in immature infants: a randomized controlled trial2003n=391
An RCT of 391 premature infants found NAC (32 mg/kg for 6 days) did not prevent bronchopulmonary dysplasia versus placebo.
- Effect
- No Benefit
- Duration
- 6 days
- Dose
- 32 mg/kg
- Population
- Infants
- Participants
- 391
RCTIntratracheal N-acetylcysteine use in infants with chronic lung disease1992
An RCT found intratracheal NAC in infants with chronic lung disease did not significantly improve long-term pulmonary outcomes.
- Effect
- No Benefit
- Duration
- 1 week
- Population
- Premature infants
ZeaxanthinView supplement →
Do not purchase·★★★★★
How we scored this▸
- It is not known if taking zeaxanthin by itself helps prevent bronchopulmonary dysplasia (a lung condition) in premature or low birth weight babies.
- In studies, giving a supplement with very small amounts of zeaxanthin and lutein daily from birth to about 36 weeks did not lower the chance of developing this lung condition compared to not taking it.
- The effect of zeaxanthin alone is unclear.
Browse 1 study
RCTLutein and zeaxanthin supplementation in preterm very low-birth-weight neonates in neonatal intensive care units: a multicenter randomized controlled trial2013n=229
In a multicenter RCT in preterm infants, lutein/zeaxanthin supplementation did not significantly reduce retinopathy of prematurity, NEC, or BPD versus placebo.
- Effect
- No Benefit
- Dose
- 0.14 mg lutein + 0.0006 mg zeaxanthin/day
- Population
- Infants
- Participants
- 229
Evidence visualised
Same ratings as above, aggregated so you can see coverage and imbalance.
| Supplement | DEX | Studies | Meta-analyses | Share |
|---|---|---|---|---|
| Vitamin A | ★★★★★40% | 9 | 4 | 47% |
| N-Acetyl Cysteine (NAC) | ★★★★★32% | 2 | 0 | 11% |
| Vitamin E | ★★★★★36% | 2 | 0 | 11% |
| Algal Oil | ★★★★★32% | 1 | 0 | 5% |
| Fish Oil | ★★★★★36% | 1 | 1 | 5% |
| Lutein | ★★★★★32% | 1 | 0 | 5% |
| Melatonin | ★★★★★44% | 1 | 0 | 5% |
| Vitamin D | ★★★★★48% | 1 | 1 | 5% |
| Zeaxanthin | ★★★★★32% | 1 | 0 | 5% |